Our Progress in Healthcare
CASE FOR SUPPORT
A Skilled Nursing Shortage
The healthcare industry currently comprises 13% of Vermont’s jobs. According to Vermont Labor Market Information, healthcare employed approximately 37,625 people in the first half of 2021, up approximately 1% from calendar year 2020, yet 4% lower than the pre-pandemic levels of 2019. Vermont has recently joined the interstate nurse licensure compact, therefore any nurse licensed in a participating state is eligible to work in Vermont. This recent legislation will allow for an increased hiring pool for Vermont healthcare facilities. Since the pandemic, emergency rule flexibility has been provided by the Legislature to waive exams and fees for Vermont license and re-licensure, to expand the number of nurses who can practice in our state.
Organizing the Healthcare Collaborative
The Vermont Talent Pipeline’s Healthcare Collaborative is comprised of 43 Vermont hospitals, residential care, and home health organizations, which are diverse in size and geography. They initially convened in 2018 to address the shared needs for skilled talent, primarily in the field of nursing. All levels of nurses were found to be in short supply. The collaborative convened again in 2021 conducting a new needs assessment to understand the changing needs in Vermont’s healthcare industry. Traveling nurses are currently hired by even the smallest employers to meet daily care requirements. And with an aging population, we see an exponential demand for nurses with more retirements and more care needed.
Participating Healthcare Collaborative employers identified seven critical jobs categories representing their greatest need for new and replacement hiring between 2021-23. VTPM forecast a demand for 6244 nursing FTEs, with related credentials, using a needs assessment survey for these critical jobs:
Licensed Nurse Assistants (LNA)
Licensed Practical Nurse (LPN)
Clinical Nurse Educators
VTPM produced a report in 2018 and 2021 for Vermont’s nurse education providers, relating to the industry’s hiring demands. The reports provide both a qualitative and quantitative summary, the competencies required for short-term training in “stackable” high demand skills within education pathways.
On the supply side, Vermont’s Higher Education Nursing programs identified clinical educators as the top barrier to growth. With an estimated $115M in 2021 budgeted for hospitals and residential care facilities traveling nurses (VAHHS and VHCA), tapping investments in Education for those most likely to stay and work in Vermont could produce the best return on investment. In August 2018 we learned that Vermont Technical College produces approximately 65% of all licensed skilled nurses in Vermont, and they have the best retention rates for nurses of any Vermont training provider. Not surprisingly VTC licensure candidates are mainly non-traditional students, many who benefit from VTCs 1+1+2 program (LPN, ADN, and BSN) and work while gaining their education.
The barrier to educational expansion was identified as the need for clinical education instruction and placements. Next steps will rely on the healthcare community to provide clinical experiences using trained practicing nurses. Other improvements involve workplace shift supports, hiring efficiencies, career awareness and preparation activities with on-ramps for middle, high school and adult candidates.
In 2021 we forecast a need for 1300 Registered Nurses in Vermont per year, while in 2019 only 293 completed RN licensing programs. In an effort to double the number of students licensed in the next several years, we’re planning for larger and more skilled nursing applicant preparation. A series of four prerequisites (available at CCV and Vermont’s Career and Technical Center with dual enrollment options), we’re improving the number and quality of applicants, and those with an additional LNA credential, too.
But there’s more work to be done! Though we’re building a training pipeline with stackable credentials, only a given % of licensed nurses will remain in Vermont without a thoughtful implementation of best employment practices. Employer goals for 2021 include investing in clinical educator training and coordination with Vermont nurse educators. Additionally, we hope to layer federal apprenticeship funding to assist employers in growing their own people. Working together, we will double the number of enrolled applicants who are better prepared to attain licensure and specialty experience, thereby reducing the costs for traveling nurses and the mounting costs associated with turnover.
Stackable nursing credentials provide a low-barrier on-ramp to the nursing profession, that progress with experience and education levels. Studies show a 94% retention rate for four years following apprenticeship completion. Apprenticeships invite all ages to enter a career path with training and pay within the safe, productive, high-paying field of nursing.